Objectives of the research are (1) to develop and test effective behavioral medicine (biofeedback) training procedures for treating fecal incontinence in meningomyelocele patients, and (2) to determine the physiological mechanism underlying fecal incontinence in this group and the physiological mechanism by which biofeedback training results in the establishment of bowel control in some patients. Biofeedback training utilizes a 3-balloon tube to distend the rectum and to measure the response of the anal sphincters to rectal distension. In Experiment I, 10 patients have been provided biofeedback training of whom 4 have completed training. Three of these learned to emit adequate sphincter responses and two achieved significant reductions in the frequency of incontinence. Twenty to twenty-five additional patients will be studied in the second year. Data are being collected which would permit an analyisis of the continence mechanism. Also in the second year we will begin an experiment to compare the effectiveness of feedback derived from balloon probes to feedback from skin-surface EMG electrodes adjacent to the external anal sphincter.